HealthDay News – Beta-blockers may not be the medicine of choice for nursing home residents with dementia, according to a study published online in JAMA Internal Medicine.1,2
For the study, Michael Steinman, MD, professor of geriatrics at the University of California, San Francisco, and the affiliated San Francisco VA Health Care System, and colleagues included 10,992 nursing home residents aged 65 years and older who had survived an acute myocardial infarction, after which half of the patients were prescribed beta-blockers.
The researchers found that beta-blockers reduced the number of deaths within 90 days by about a quarter. But use of the drugs was also associated with 34% higher risk of reduced ability to perform daily functions independently in patients with moderate or severe dementia. No such effect was seen in patients with normal mental function or mild dementia. Use of beta-blockers also did not impair daily function in patients who were not already highly dependent on others to help them with basic daily activities.
The new findings highlight “how the potential mortality benefits of drugs can be balanced by harms to quality of life in older adults, and how to manage that risk-benefit trade-off,” Dr Steinman said in a university news release.
- Steinman MA, Zullo AR, Lee Y, et al. Association of beta-blockers with functional outcomes, death, and rehospitalization in older nursing home residents after acute myocardial infarction [Published online December 12, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2016.7701.
- Tjia J, Lapane K. Guideline-based prescribing in frail elderly patients [Published online December 12, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2016.7714.